Trigeminal Neuralgia

TRIGEMINAL NEURALGIA is an extremely severe facial pain that tends to come and go unpredictably in sudden shock-like attacks. The pain is normally triggered, for example by light touch, and is described as stabbing, shooting, excruciating or burning. It usually lasts for a few seconds but there can be many bursts of pain in quick succession.

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What is TN?

The trigeminal nerve is the fifth cranial nerve and its function is to send pain messages to the brain. When the nerve malfunctions, pain messages are sent at inappropriate times and the pains can be of great severity. In fact, TN is regarded as the most painful condition that is known in the medical world.

The pains are variously described as like a strong electric shock shooting through the face, or very intense sensations of stabbing and burning. TN affects more women than men and pains are normally felt on one side of the face only, generally the right-hand side. The majority of people affected are over 50 years old although young adults, and very rarely children, may also develop the condition.

The trigeminal nerve has three branches (or divisions) on each side of the face:

Opthalmic branch which runs above the eye, forehead and front of the head

Maxillary branch which runs through the cheek, upper jaw, teeth and gums, and to the side of the nose

Mandibular branch which runs through the lower jaw, teeth and gums.

TN pains can result from one or more branches but the middle and lower branches are most frequently affected.

What are the Causes of Trigeminal Neuralgia?

More research still needs to be undertaken into TN but the transmission of abnormal messages of pain often appears to result from damage to the protective coating (myelin sheath) around the trigeminal nerve. There are several possible causes of damage, including pressure from blood vessels or arteries, and, very rarely, tumours or multiple sclerosis.

Diagnosis

There is no diagnostic test for TN, so the patient’s description of the pattern and nature of the pains is vitally important when it comes to getting an accurate diagnosis. An MRI scan may show a compression of the trigeminal nerve by a blood vessel but even if no compression is visible, the cause of the pain may still be TN.

Treatments

Anti-convulsant medications are normally prescribed for people with TN and there are also a number of surgeries available which offer relief. However, unless the diagnosis is classic TN, surgical procedures may make the pain far worse. For this reason, it is important to research the condition thoroughly with the help of an informed specialist before making any decisions on treatment.